Ethical Considerations for Working with Military Members and Veterans

DESCRIPTION:

Civilian mental healthcare providers working with military service members and veterans often face ethical challenges unique to this population. Personal and professional ethical practice is contingent on effective application of personal and cultural morals, and professional regulations and expectations. Comprehensive understanding of informed consent, boundaries of cultural and clinical competence, disposition-driven diagnoses, multiple relationships, and professional fitness are all discussed in breadth and depth in the context of civilian practitioners working with military-connected clients. Decision-making models are presented to address ethical dilemmas, with specific discussion of the role of dual-relationships within a clinical framework. Extensive, complex vignettes are discussed in workshop/group format to ensure comprehensive, nuanced discussion.  

LEARNING OBJECTIVES:

1. Consider the definition of ethics and how it relates to the role of the mental health provider.
2. Explore five (5) ethical challenges common to mental health providers working with the military population.
3. Implement Gottlieb’s model for avoiding dual relationships.
4. Apply knowledge of the ethical decision making process to military case examples.

OUTLINE:

1. Definition of ethics
   1. General terms
   2. Professional code
   3. Process
   4. Personal
2. Define an ethical dilemma
   
   1. Ethical Dilemma
   2. Ethical Conflict
3. Decision-Making Process and Models
   
   1. Themes of processes to make ethical decisions
   2. Strategies for managing ethical concerns
      
      1. Forensic Psychology ethical decision-making model
4. Common ethical challenges for civilians to be mindful of when working with military members and veterans
   
   1. Boundaries of competence
      1. What is military culture?
      2. Methods to increase cultural competence
      3. Need for competency in both cultural and clinical realms
   2. Informed Consent
      
      1. Limits of confidentiality
      2. Need for a detailed informed consent procedure
   3. Disposition-driven diagnoses
      
      1. Military regulations and mental health dispositions
      2. Dangers of disposition driven diagnosis
   4. Multiple/dual roles
      
      1. Types of dual roles
      2. Gottlieb’s 5-step model to avoid Dual Relationships
   5. Professional’s own fitness
      
      1. Self-care
      2. Ethics guidelines regarding provider impairment
5. Vignettes, Discussion, and Workshop
   
   1. Boundaries of competence: military cultural competence, clinical competence  
   2. Informed consent: accurate documentation, duty to warn, confidentiality
   3. Disposition-driven diagnosis: accuracy of diagnosis, change in roles, boundaries of comp
   4. Multiple relationships: dual roles, change in roles
   5. Professional fitness: Work-life balance, impaired provider, do no harm